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Travel vaccinations

Published by Bupa’s Health Information Team, July 2011.

This factsheet is for people who would like information about travel vaccinations.

Different countries can have diseases that you don’t get, or aren’t very common, in the UK. Vaccinations can prevent people from becoming ill or even dying from an infectious disease.

About travel vaccinations

Depending on where you go, you may need to have vaccinations before you travel. It’s best to see your GP about six to eight weeks before you go. If there are less than six to eight weeks before you plan to travel, still go to your GP or travel clinic as it may be possible to get vaccinated.

If you need to have a course of vaccinations, this can be at different times over a number of weeks. The time between injections will allow your body to respond to the vaccine, so you develop immunity ready for when you arrive. Generally you will have vaccine injections in your upper arm or on the outside of your upper thigh.

You’re unlikely to need any vaccinations if you’re going to the United States, Western Europe, and most parts of Australia or New Zealand. But it’s important to make sure that your booster immunisations for tetanus, diphtheria and polio are up-to-date.

You will need to pay for most travel vaccinations – only some are available for free on the NHS.

Cholera

Cholera is an infection of the small bowel caused by the bacterium Vibrio cholerae. It’s usually spread through water contaminated with infected faeces. Cholera is mainly found in places of poor hygiene and sanitation, such as Africa, Asia, the Middle East, Peru and some parts of Central America.

If you’re travelling to an area that has a cholera epidemic (a widespread occurrence of an infectious disease in a community at a particular time), you may need to have a cholera vaccine. The Department of Health advises that people who are relief or disaster aid workers, or who are in places where there is limited access to medical care, should also have the vaccine.

The cholera vaccine is given orally (you take it by mouth), and comes in sachets that you dissolve in water. Don’t eat or drink anything one hour before or after you take the vaccine. You will need to have two doses between one and six weeks apart. Make sure you have the second dose at least a week before you travel.

The cholera vaccine doesn't give you lifelong immunity and you will need to have a booster to keep you protected. Adults and children over six need the booster two years after the initial dose and children aged two to six need it six months after.

Hepatitis A

Hepatitis A is a liver disease caused by an infection with the hepatitis A virus. People usually become infected by eating contaminated food or drinking contaminated water.

If you’re travelling to an area with a high risk of hepatitis A infection, such as Africa, the Middle and Far East and southern and eastern Europe, it’s advisable to have a course of vaccines.

You will need to have two hepatitis A injections – the second is a booster dose that is usually given six to 12 months after the first. It’s best to have the first injection about two weeks before you travel, but it’s possible to have it the day before you leave. The vaccine (including the booster) can give you up to 20 years of protection.

You can have a combined vaccine, which protects against hepatitis A and B, or one which jointly protects against hepatitis A and typhoid. However, you will need to have separate boosters for each disease for more long-term protection.

Hepatitis B

Hepatitis B is a liver disease caused by infection with the hepatitis B virus. You can get it by having contact with an infected person’s blood or other body fluids, for example semen or vaginal fluid.

The disease occurs worldwide but is more common in South Asia, Africa, the Middle East, the Far East and southern and eastern Europe.

You’re more at risk of getting hepatitis B if you have unsafe sex, use contaminated needles and syringes to inject drugs, are doing relief work or are participating in contact sports in an area with hepatitis B. Also, If you’re planning to stay for a long time, are visiting friends or relatives with chronic hepatitis B infection, or are adopting a child from a country with widespread hepatitis B, you should consider having the vaccine.

There are different immunisation schedules, but generally you have three doses. After the first dose, you will need the second a month later and the third five months after the second dose. If you need to be vaccinated quickly, you can ask for a rapid schedule and have a full course over two months or even three weeks.

Japanese encephalitis

Japanese encephalitis is a viral infection that is passed on through mosquito bites. It’s common in areas such as South-East Asia, India, the Far East or tropical North-East Australia.

You may need a vaccine if you’re travelling to an endemic area (a place where a particular disease is regularly found) for a month or longer, especially if you’re going to rural areas. Ideally, you should get vaccinated a month before you travel.

There are two vaccines, but only one (Ixiaro) is licensed in the UK. For this you need to have two doses 28 days apart. The vaccine is not licensed for children under the age of 18. You will need to have a booster about 12 to 18 months after the initial vaccination if you’re still at risk of the disease.

Meningococcal meningitis

Meningococcal meningitis is an infection that affects the thin lining that surrounds the brain and spinal cord. It’s caused by the bacterium Neisseria meningitidis and is common in parts of Africa and Saudi Arabia.

If you're staying in a country with a high risk of meningitis for a month or more, or you're backpacking or living in a rural area, you will need to have a combined vaccine against the A, C, W and Y strains of meningitis. Saudi Arabia requires proof of this before you can enter the country.

You should have the combined vaccine two weeks before you travel. Adults need just a single dose. Children (over one) will need to have the vaccine two months before travel and will need to have two doses, one month apart.

The timing of a booster vaccine will depend on the specific type of vaccine you have. If you have the ACWY Vax for example, you (and children over five) will need a booster every five years if you’re at continued risk. Children under five need a booster every two to three years.

Rabies

Rabies is a viral infection that can be spread from animals to people. People usually catch it after being bitten by an infected animal, often a dog. Rabies is common in developing countries, and especially in Africa, Asia and South America.

You may need a rabies vaccine if you’re travelling for a month or more to an area where the risk of rabies is high and medical care isn't easily accessible. Or, if you’re travelling for less than a month but may be exposed to rabies due to your activities – for example working with animals that may be infected.

If you need the rabies vaccine, you will be given three injections. You will have the second a week after the first, and the third after a further three weeks (or after a further two weeks if there isn't enough time before you travel). After this, you will need a reinforcing dose a year later and a top-up every two to five years, depending on your risk of getting rabies.

Having the rabies vaccine doesn't mean you're immune to the disease. However, if you get bitten, it may give you more time to seek medical treatment before the symptoms develop.

Tetanus, diphtheria and polio

In the UK, you will usually have had the tetanus/diphtheria/polio vaccines (Td/IPV) during childhood – unless you were born before 1958 when the vaccine programmes were introduced.

Tetanus is common in Asia, Africa, and South America in agricultural regions and in areas where contact with animal waste is more likely.

If you're travelling to a country with tetanus, diphtheria or polio, you will need a booster if you haven't had one for 10 or more years, or if you haven't been immunised before. Adults and children aged 10 or over who haven’t been vaccinated will need to have three doses one month apart, and two boosters. The first booster is given five to 10 years after the initial dose and the second 10 years after.

Tick-borne encephalitis

Tick-borne encephalitis is a viral infection that is passed on through tick bites. There are different types of the disease, which are linked to the area they are found in – Europe, the Far East and Siberia. It’s mainly found in forested locations.

The vaccine is given in three doses. After the first dose you have the second between one and three months later, then the third dose five to 12 months after the second. If you need more immediate protection, you can have two doses, two weeks apart.

Typhoid

Typhoid is caused by the Salmonella enterica serovar typhi bacterium. Paratyphoid fever is a similar illness caused by strains of Salmonella paratyphi. You can get typhoid by eating contaminated food or drinking contaminated water. Typhoid outbreaks are common in Asia, Africa and Latin America.

Getting vaccinated against typhoid is important if you're planning to stay in areas where sanitation and food hygiene are poor. There are two licensed vaccines in the UK – the typhoid Vi polysaccharide injection, and an oral typhoid vaccine. Both give some, but not complete, protection against typhoid. You may be able to have a combined typhoid and hepatitis A vaccine, if available – check with your GP or travel clinic. After you’ve had the vaccine you won't need another one for three years.

Yellow fever

Yellow fever is a disease caused by a virus and is passed on by mosquito bites. It mainly occurs in tropical areas of Africa and South America.

You will need to have the yellow fever vaccine if you're going to or travelling through a country affected by the disease. Some countries require you and any children travelling with you to show certificates to prove you have been vaccinated before you can enter. If you have a child of less than nine months travelling with you, ask a health professional for advice.

You will need to have the yellow fever vaccine at least 10 days before you travel. A certificate will be issued that lasts for 10 years. You can have a booster after 10 years if you’re still at risk.

Getting vaccinated

As part of your travel plans, you should organise a visit to your GP or a travel clinic to have any vaccinations you may need. This should be about six weeks before you travel. You may need a course of vaccinations which will involve two or three injections at different times over a few weeks. This time between injections lets your body respond to the vaccine so you develop immunity to protect you against infection. Vaccine injections are generally given in the upper arm or on the outside of the upper thigh.

If there are less than six weeks before you plan to travel, you should still go to your GP to ask for advice before you set off. You may still be able to be vaccinated. There may be an option to have a course of injections over a shorter period.

You will have to pay for travel vaccinations.

 

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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  • Publication date: July 2011